Rocuronium Bromide (Zemuron)

Defasciculating - Rocuronium can be utilized to reduce/eliminate fasciculations. Fast acting - this is one of the great advantages of rocuronium. Reversible - another big advantage of rocuronium is fast reversibility with suggamadex. This is a distinct enough advantage that rocuronium can be used in emergency situations to facilitate difficult intubation where succinylcholine is unavailable or contraindicated. Prolongation - rocuronium can be prolonged by hypothermia, hypovolemia, volatile inhaled agents (sevoflurane, desflurane, etc.), and renal and hepatic diseases Blood pressure - the literature states that rocuronium has no effect on blood pressure. By clinical experience, rocuronium lowers blood pressure fairly profoundly.

Renal or hepatic dysfunction Allergic reaction to rocuronium Alert (non-sedated) patients

Intubation - 0.6 to 1.2 mg/kg. Higher doses (1.0-1.2 mg/kg) produce faster onset times of ~1 min (similar to succinylcholine). Defasciculating - 1/10th the intubating dose.  Clinically, it is usually ~ 5mg. Obese - use LEAN body weight

Rocuronium acts on the post junctional nicotinic receptors at the neuromuscular junction by blocking acetylcholine.

Rocuronium is excreted unchanged in bile and about 30 % renal excretion.

Blood-Brain Barrier - Rocuronium does NOT cross the blood brain barrier OB - Rocuronium does NOT cross the placenta.